METABOLIC RESPONSES AFTER LAPAROSCOPIC OR OPEN HERNIA REPAIR

Background: The purpose of a prospective randomized study was to compa re the surgical trauma in patients undergoing laparoscopic or open her nia repair. Methods: Postoperative pain, analgesic consumption, and me tabolic response to surgery were assessed in 30 patients undergoing la paroscopic (group 1; n = 15) or open (group II; n = 15; Shouldice repa ir) unilateral inguinal hernia repair. Both groups were comparable wit h respect to age, sex, and type and size of inguinal hernia. Results: Postoperative visual analogue scales (VAS) for pain were reduced on mo bilization for patients of group I with a significant difference (P = 0.02) on the operative day, whereas pain scores at rest and analgesic requirements were similar for both groups. No differences between grou ps I and II were found in postoperative levels of interleukin-1, inter leukin-6, tumor necrosis factor alpha, C-reactive protein, fibrinogen, transferrin, alpha-1-antitrypsin, and white blood cells, Postoperativ e polymorphonuclear (PMN) elastase concentrations remained within norm al range in group II but showed a significant increase in patients ope rated laparoscopically for postoperative days 1 and 2. Conclusions: No major surgical trauma was found after herniorraphy compared to open h ernia repair.